Development and implementation results of an interactive computerized surgical checklist for robotic-assisted gynecologic surgery

Abstract

To address surgical complications, the World Health Organization (WHO) developed the Safe Surgery Saves Lives Checklist. With the foundation of the WHO's checklist, a robotic-specific checklist (RORCC) was developed using standardized content and face validity methods. The RORCC was implemented in a high volume gynecological (GYN) specialty group using minimally invasive robotic-assisted surgery. Data were abstracted from patients undergoing GYN procedures from four GYN surgeons at an urban, community hospital during November 16, 2010 to May 15, 2011 (pre-RORCC) n = 89 and from the period May 16, 2011 to November 16 2011 (post-RORCC) n = 121. Thirty-day readmissions pre-checklist and post-checklist were 12 and 5, respectively, which is a significant (p = 0.02) reduction. The duration of surgery was not significantly affected (p = 0.40) with pre-RORCC surgery time at 110.1 (35.7) min versus post-RORCC surgery time at 112.9 (37.4) min. This study demonstrated the feasibility of integrating an electronic, interactive, and robotic-specific checklist for gynecologic robotic-assisted surgery which resulted in a significant reduction in readmissions at the 30-day without significantly impacting operating room times.

The effects of safety checklists in medicine: a systematic review

“…The original Dutch and the Indian SURPASS studies did not report on unplanned readmissions, so ours is the first to investigate effects of SURPASS checklists use on this. While several WHO SSC studies have shown a reduction in readmissions 87,91,98,108 , other such studies showed no such change 88,105 .…”

“…Favourable patient outcomes were associated with the use of WHO SSC in several studies with reductions in complications 10,19,92,[94][95][96][97][98][99][100][101][102][103][104] , mortality 10,11,62,88,94,102,105,106 , unplanned reoperations 10,19,99,107 , and unplanned readmissions 91,98,108 , LOS 19,89,105,106 , while other studies reported no significant changes after introduction of the WHO SSC as to complications 89,93,106,[109][110][111][112][113][114] , mortality 19,89,91,93,95,[97][98][99]…”

Integrative Literature Review Examining Factors Affecting Patient Safety With Robotic‐Assisted and Laparoscopic Surgeries

“…The study characteristics are presented in Table S2. Six of the 12 studies reviewed focused on laparoscopic procedures (Al‐Hakim, ; Hafford et al., ; Murji et al., ; Sevdalis, Hull, & Birnbach, ; Silvennoinen, Antikainen, & Mecklin, ; Stavroulis, Cutner, & Liao, ) and 6 focused on robotic‐assisted surgeries (Allers et al., ; Catchpole et al., ; Friedman, Lendvay, & Hannaford, ; Jing & Honey, ; McCarroll et al., ; Randell et al., ). Six studies used a qualitative methodology, all of which used thematic data analysis with the exception of Silvennoinen et al.…”

Are perioperative bundles associated with reduced postoperative morbidity in women undergoing benign hysterectomy? Retrospective cohort analysis of 16,286 cases in Michigan

“…5–7 However, evidence supporting the use of perioperative bundles for hysterectomy and what processes they might contain is lacking despite the fact that over 400,000 women per year undergo the procedure in the U.S. 8 Therefore, the aim of our study was to evaluate a perioperative bundle of evidence-based processes for benign hysterectomy and retrospectively evaluate its impact on postoperative outcomes using a statewide hysterectomy database.…”